Newly Diagnosed with RA mom On MTX - Are Biologics Worth It?
Hi! I was diagnosed with RA in November of 2024 when I was two months postpartum. My RF was high when the blood work came in ( about 515) or so. I was put on Mtx (25 mg). I inject the mtx weekly and started medication in late December of 2024. I have monthly flares, and still in somewhat pain but the pain is bearable (2/10 worse is 3/10). The flares come before my menstrual cycle and during my cycle from what I noticed. My baby is now 8 months old and is starting to learn how to crawl and I want to be in less pain and have less flares up. I am having a hard time understanding if I need more medication to control my RA or if it's a question of time to let the MTX work into my system. There are weeks where I feel great with no pain and then there are weeks where everything aches. I've taken mtx for about 5 months now. I am feeling way better now and can move way better than where I was 5 months ago. I can move every joint with no problem unless I have a bad flare on that joint. My mobility is great now, but the flares and the knee pain worry me and bother me. I am on a anti-inflammatory diet but lately I have ventured into different foods so I am not sure if this had something to do with the flaring. I also have a full time job and a baby and a household that I juggle daily. I also have bad anxieties and started to take medication as of January and the anxiety medication has helped tremendously.
My doctor said that we can "try" Humira more or so to make me happy and didn't really feel as it if I needed. I guess, he is not worry about my flare ups, but I am. I did seek a second opinion and that Rheumatologist told me that I pretty much needed Humira due to the amount of flares up that I had. I take metho-pred for my flare ups when they occur.
I am unsure and very scared to take a Biologic, specially Humira or any biologic because of the side effects. I do feel like I would be way more comfortable and in better shape with a biologic but I' scared to take it. I also don't know if I really need it because other factors may or may not be contributing to my flare ups. I also wanted to try Orencia but my insurance wants me to try Humira or other drugs in that same category before they pay for Orencia. I am so unsure on what to do and what direction to take and would greatly appreciate your feedback and suggestions. I just want to be well and comfortable so I can do more things with my baby as he starts to grow and enter new phases. Thank you so much!
I am in a similar position, but on methotrexate and leflunomide since 2007. Nodules, few flare ups,knees, neck and low back pain recently started up. Would Humira be of any use? Or do I stay on methotrexate?
Good Morning Pam88
I can definitely relate to your story, I was diagnosed with RA May of last year. My Husband ❤️♥️, I actually went on vacation and then the last day of our vacation. Something triggered it and that’s how the on side of my RA came out. I started out going to the podiatrist nothing‘s wrong with my feet but my feet felt like they were on fire and I was walking on glass. They did so many different tests on me in the last test that they actually ran was RA my RA factor was super super high so I got lucky there for them to be able to figure out that’s exactly what it was. I started out with methotrexate. Pill form. My first on go with that I got super super sick, I actually had severe flu like symptoms and I was throwing up. So I reported back to my RA. She said let’s try one more dose and see how it works. So the next round of Methotrexate because I was taking it weekly, I had the same exact symptoms. So she moved me to leflunomide! Within three weeks, I started to feel a difference. I had to quit my job because I was almost debilitated. I couldn’t walk everything happened so fast. The leflunomide did give me about half of relief. But it just wasn’t strong enough. So my RA said let’s try a biologic cocktail, so she introduced Humira along with my leflunomide . I was very skeptical myself due to the side effects but at this point, I believe I was just kind of desperate and didn’t have anywhere else to go. So I’ve been on Humira for six months now I’m doing great. I do have occasional bad month and then an occasional good month. The only struggle that I have right now is I have some serious deterioration in my left ankle so I’m getting that under control but other than that the Humira has done wonders for me along with the leflunomide.. one thing I have learned it is a very long journey to find that specific medicine that works, I have went through it myself but once they find that cocktail, it’s like a big breath of fresh air. 😮💨 I hope this gives you some type of relief and set your mind at ease.Hi
. So glad to hear you are noticing improvement with the Orencia. While the combination therapy works for many it is not the best or necessary route for everyone. My wife, Kelly Mack (a contributor here), was diagnosed with a severe case at age two, 46 years ago. She has used a wheelchair since childhood. When the time came to finally try a biologic her rheumatologist wanted to proceed with caution (she already had to have a revision of a knee replacement due to a serious infection), so he took her off the methotrexate and tried the biologic as a solo treatment to start. It took some trial and error, but they found a biologic that brought her inflammation numbers into the normal range for the first time ever. Hoping the Orencia is that treatment for you. Best, Richard (Team Member) Hi Candy. Thank you for sharing that story. I actually had the same problem with my feet as if I was walking on glass I couldn’t hardly walk at all after I started the methotrexate with the prednisone. I could at least walk outside. I had a problem with shoes none were comfortable until I bought Brooks ghost they seem to work good in fact I still have them. I’m walking up to a mile a day with super feet inserts the black ones my doctor recommended them. I tried getting off the prednisone but all the pain came back so I’m still on 2.5 mg a day. It seems to work and the add on a placquinal because the flares were coming back as far as diet goes I have to really watch what I eat because I know certain things will bring on a flare. I try and stick the low FOD map diet cause I also have IBS so sometimes it seems to work then if something contains too much salt my joint swell up and I’m in pain again. Thanks everyone for sharing your stories. It’s so nice to go someplace to talk about this and people understand how you feel take care.
I share your concerns about the biologics. Have made a decision to stick with methotrexate and leflunomide rather than start on Humira. Neither the rheumologist nor rheumatology nurse could guarantee things would improve with Humira. I have started to use ivermectin 12 mg once a day for inflammation, for one week. I use ivermectin if I am around anyone with covid who,is coughing or sneezing. I never took the covid vaccines. I had Covid a few times, now never get it. Here in the Uk I noticed rheumatologists and their specialty nurses never ask about diet or exercise. Both are so important in the mgmt of this disease.
It’s surprising to hear there's little focus on lifestyle factors like diet and exercise when they both can make such a big difference in one's RA journey. How have you been feeling since deciding to stick with Methotrexate and Leflunomide? -Latoya (Team Member) Hey! I hear you, I was shaken when I first tried Humira and was scared but I focused on something. For me, it’s my baby and getting better and doing more with him so I closed my eyes and thought about him and was able to take the shot and continued to use it. It did make a difference along with methotrexate but I cant tolerate mtx so I stopped taking it. I have seen a huge improvement with the biologist than the DMARD’s. I do follow a specific diet and do exercise as well, that is important. Rheumatologist won’t mention a diet to follow but diet and exercise/movement helps. I would say to you, don’t be afraid to try, sometimes fear locks in a box and doesn’t allow us to explore new possibilities/ opportunities. I’m wishing you the best. Nice connecting with you ❤️
Hi
. Your concerns are certainly understandable, but I do want to note that many people take biologics to great effect. In fact, one thing I want to note is that methotrexate is actually a blanket immunosuppressant, while biologics inhibit a specific part of the immune system. This is why those on methotrexate had stricter guidelines for stopping the drug for COVID vaccination than biologics had. I want to share with you this article from our contributor Amanda on questions to ask the doctor before starting a biologic: https://rheumatoidarthritis.net/living/questions-ask-biologics. I strongly encourage you to read the extensive comments section at the end of the article for good conversation and input into the topic of biologics. I hope this information is helpful and finally want to stress, that at the end of the day the choice always belongs to you as the patient. Collect the information, listen to the input from your doctors and make the decision that you feel is best for you. Wishing you the best and please feel free to keep us posted and to ask further questions. Richard (Team Member) Richard, you are so helpful. I am seeing a dentist now to treat some dental issues and we are going to do a night guard so thanks for that.
I have a little one at home and he just started day care. He pretty much started day care a few weeks before I started my Orencia infusions. It has taken me over a month to get over a virus that I caught from my son. It's been rough! I am in such a bad spot because and I don't know how to navigate this. Daycare is helping my son on every aspect but he is catching and fighting every virus that goes through that daycare. My immune system being suppressed is taking a hit constantly. I am taking vitamins from Cell core which is multi vitamin that aids inflammation and I love it. Not sure if you can give me any advice on what I can do to help my immune system during this time. Thanks for all your help!Hi
. I wish there was some plan for how to avoid the germs that come with children in daycare or to improve the immune system for you, but the reality is that anything that boosts the immune system is counterproductive for the RA treatment. How long have you been on the Orencia? Also, was your previous treatment Humira with leflunomide? I ask because the Orencia blocks only one part of the immune system, while the combination therapy inhibits more of the immune system, particularly leflunomide. Best, Richard (Team Member)
